CHIP Pharmacy & Drugs


CHIP Pharmacy

FirstCare CHIP members can access prescriptions through any pharmacy that is contracted with the Navitus Health Solutions. Navitus administers prescription benefits for FirstCare CHIP Members.

Find Your Pharmacy

Find a list of in-network pharmacies by using the tool below. Navitus Health Solutions, FirstCare's pharmacy benefits manager, has provided this tool to help you locate the closest and most convenient pharmacy for you. Click below to get started.


The Pharmacy Directory is also available on our website.

Formulary

FirstCare uses the state mandated CHIP formulary. The formulary is available on the Texas Medicaid Drug Vendor Drug Program website.

Click here to download the PDF of the Texas CHIP Formulary.

The Texas CHIP Formulary is available in paper form without charge. To request a copy, please call FirstCare CHIP Customer Service at 1-877-639-2447.

Prior Authorizations

To obtain a prior authorization, providers should call Navitus at 1-877-908-6023. To access drug specific prior authorization forms, please visit the Navitus website.

Pharmacy Provider Manual

To obtain a copy of the Pharmacy Provider Manual, please visit the Navitus website.

For pharmacy questions, contact Customer Service at 1-877-639-2447.

Pharmacy Maximum Allowable Cost (MAC) List

To obtain a copy of the MAC List, network pharmacies may visit the Navitus pharmacies website and go to the MAC Program link: pharmacies.navitus.com

News

Medicaid Allows Pfizer BioNTech COVID-19 Vaccine for Emergency Use in Adolescents  For additional information click here.

HHSC to Resume Quarterly Specialty Drug List in July 2021  For additional information click here.

COVID-19 Testing in Pharmacy Reimbursable Through Medicaid Medical Claims System  For additional information click here.

Clinical Prior Authorization Assistance Chart Now Available  For additional information click here.

April 2021 Preferred Drug List Recommendations Now Available  For additional information click here.

COVID-19 Vaccine Administration Rate Change Effective April 1, 2021  For additional information click here.

January 2021 Preferred Drug List Decisions Now Available  For additional information click here.

Enzymes Clinical Prior Authorization Criteria Revisions Effective June 30, 2021  For additional information click here.

Frequently Asked Questions about the Medicaid Standing Order for Mosquito Repellent  For additional information click here.

Epidiolex Prior Authorization Revision Scheduled for May 11, 2021  For additional information click here.

Medicaid Adds Johnson & Johnson COVID-19 Vaccine to Formulary  For additional information click here.

Revised Hepatitis C Drug Prior Authorization Form 1342  For additional information click here.

January 2021 Preferred Drug List Revised March 5, 2021  For additional information click here.

Revisions to Cytokine and CAM Antagonists Prior Authorization Criteria Set for May 4, 2021  For additional information click here.

RSV Season Extended for Counties in Southeast Texas and Gulf Coast Areas  For additional information click here.

Monoclonal Antibody for Asthma Prior Authorization Updates Set for April 6, 2021  For additional information click here.

Revised Hepatitis C Drug Prior Authorization Forms Now Available  For additional information click here.

Clinical Prior Authorization Updates for Cystic Fibrosis Agents  For additional information click here.

Preferred Drug List Criteria Exception for Macrolides Changes March 15  For additional information click here.

Renewed Texas Standing Order for Mosquito Repellent Benefit Available  For additional information click here.

Clinical Prior Authorization Assistance Chart Now Available  For additional information click here.

January 2021 Preferred Drug List Now Available  For additional information click here.

Desmopressin Clinical Prior Authorization Revision Begins March 15, 2021  For additional information click here.

COVID-19 Vaccine NDC Update  For additional information click here.

Dupixent Clinical Prior Authorization Criteria Revision Effective March 15, 2021  For additional information click here.

Change to Thiazolidinediones Clinical Prior Authorization Begins February 4, 2021  For additional information click here.

Medicaid Adds Moderna COVID-19 Vaccine to Formulary  For additional information click here.

Medicaid Adds Pfizer BioNTech COVID-19 Vaccine to Formulary  For additional information click here.

July 2020 Preferred Drug List Revised Dec. 16  For additional information click here.
 

Semi-annual Medicaid Preferred Drug List Update Coming Jan. 28, 2021  Preferred drugs are medications recommended by the Texas Drug Utilization Review Board. The Texas Preferred Drug List is published every January and July. For additional information click here.

Member Portal

Log In/Register

Authorization Information

Click here to access authorization information.

Access a Doctor, 24/7/365

FirstCare Virtual Care—powered by MDLIVE let’s you connect with a doctor from wherever you are. Find out more here.

Need Help?
Contact Us!

Call FirstCare CHIP Customer Service at 1-877-639-2447. 

We're open Monday through Friday, from 8 a.m. to 5 p.m., excluding state approved holidays. If you call after hours, please leave us a message. We return all calls the next business day.
 
Our Customer Service Representatives speak both English and Spanish. If you speak another language, we can connect you with an interpreter. You can get information in larger print, audio (CD), braille, or in any other language format, if needed. For help, call FirstCare CHIP Customer Service at 1-877-639-2447.

Members with hearing loss can call the Relay Texas number 711. Relay Texas is a free telephone interpreting service to help people with hearing or speech disabilities.

Resources

CHIP Service Area CHIP Member News

Talk to a Nurse—Nurse24™

Need care advice? Should you see a doctor? FirstCare members can talk to a nurse by calling 1-855-828-1013. Get answers 24 hours a day, 7 days a week! Information is available in English and Spanish. Interpreter services available upon request. TTY users can call 711 or 1-800-955-8771. Voice communication is available at 1-800-955-8770.

Utilization Management

Ever wonder how we decide to authorize services? Our decisions are based on medical evidence and consensus of health care professionals. For more details, click here.

Helpful Links and Phone Numbers

CHIPInformation and Referral:
2-1-1 or 1-877-541-7905
Enrollment Helpline: 1-800-964-2777
TTY: 1-800-735-2989 
MCNA Dental (CHIP)Medicaid & CHIP dental plan for Texas
1-855-691-6262
TTY: 1-800-955-8771
DentaQuest (CHIP)Medicaid & CHIP dental plan for Texas
1-800-508-6775
TTY: 1-800-855-2880
Navitus Health SolutionsFirstCare’s Pharmacy Benefit Manager 
1-877-908-6023
TTY: 711
OCCC Financial Literacy Information1-800-538-1579

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